New Directions: What’s Coming Down the Pike in Eyewear?

By Susan K. Treiman

Medically Reviewed by Daniel S. Casper, MD

Originally posted on Everyday Health

Glasses and contact lens technologies are slowing myopia, treating and tracking medical conditions, and changing the visible world.

Whether you view the world through rose-colored glasses, dynamic vision specs, or drug-delivering contacts, something new in vision correction is likely to change the way you see.

The $147.6 billion optical industry was already predicted to grow at a compound annual rate of 8.5 percent worldwide over the next six years, with millennials buying into eyewear as “fast fashion.” It’s now poised to make a full-blown spectacle of itself in the next decade, thanks in large part to technological advances.

One of the biggest breakthroughs is the onset of high-index lens materials that yield thinner, lighter lenses, says Michael C. Vitale, the vice president of membership and technical affairs at the Vision Council, a trade association that represents optical industry manufacturers and suppliers.

“There are also digital lenses that can be customized to each individual; contacts and glasses that slow down myopia progression (nearsightedness); and filters that block or allow specific waves of light based on patient needs,” Vitale says.

Add the ability, still on the research bench, to monitor various health conditions, magnify tiny objects, and project essential information onto the wearer’s retina, and you have a field that’s aspiring to expand beyond corrective lenses and into visual enhancement for everyone.

What follows is a sampling of vision issues that new-tech eyewear is addressing, including descriptions of the technologies and the names of some of the manufacturers and products in each category.

Slowing Myopia

Myopia (nearsightedness) among children is increasing faster than any other vision problem worldwide. By midcentury, an estimated five billion people — half the world’s population, according to an article published in February 2016 in the journal Ophthalmology — will face the blurry distance vision caused by the condition. Virtually all those people will have developed myopia between ages 8 and 15. That’s a time during which, many medical experts insist, its course can still be altered — by specialty lenses, for example.

“A lot of the focus in the corrective vision market is now on slowing the progression of advancing refractive error” — when the eye’s shape prevents incoming light from focusing correctly on the retina, says Tareq Nabhan, OD, an assistant clinical professor in the college of optometry at the University of Missouri in St. Louis.

As the Cleveland Clinic points out, extreme nearsightedness, or “high myopia,” while still a rare condition, escalates the chances that an individual will face cataracts, a detached retina, or glaucoma later in life, making the argument for early intervention even more persuasive.

Nearsightedness most commonly occurs when the eye elongates or when the cornea — the eye’s refractive and protective outer layer — becomes too curved. This prevents the light that enters through the pupil from reaching all the way to the image-sensing retina, where vision is crispest.

Anti-myopia glasses and contact lenses may function like an ocular version of dental braces, gently nudging the eye to assume a shape that more precisely aims images onto the retina, rather than in front of or behind it, by gradually promoting the flattening of the cornea.

The science of this eyewear is “based on the belief that the retina can behave like a plant does when it moves towards the sun to soak up optimal light exposure,” says Dr. Nabhan. This light-seeking behavior theory is further supported in a  December 2022 article in Science Advances.

Heredity is believed to play the biggest role in determining who develops myopia, but lifestyle may also be critical. Excessive electronic screen time, poor diet, lack of exercise, even long hours spent on close-up work may contribute to it.

The Technology: Defocus Incorporated Multiple Segments (DIMS)

DIMS spectacle lenses incorporate small, multiple segment mini lenses within the peripheral vision portion of eyeglasses to redirect incoming light.

A 2020 review in the British Journal of Ophthalmology found that lenses that gradually redirect light — altering where the light “lands” — significantly slowed the progression of nearsightedness among the youngsters tested.

The following are some of DIMS lenses that are showing initial promise, as of now. All require extensive further evaluation before they can be certified safe and effective for delaying myopia.

• StellestThe French optical company Essilor recently announced that it won U.S. Food and Drug Administration (FDA) approval for its Stellest spectacle lens to correct and slow myopia. The product’s technology, which Essilor has dubbed Highly Aspheric Lenslet Target (H.A.L.T.), features a very small array of lenses that bring light from many different areas of the eye to a single “target” point. In the first year of an ongoing clinical trial involving 170 children ages 8 to 13, researchers reported that Stellest measurably slowed myopia progression (67 percent) and axial elongation (the change in eye shape that worsens nearsightedness) among the youngsters who wore the lenses as compared to those who wore ordinary, single-vision spectacle lenses (SVL) 12 hours a day.
• MiyoSmart A collaboration between the Hong Kong Polytechnic University and the Japanese vision care company Hoya, the MiyoSmart DIMS technology involves a central spectacle lens that focuses straight-ahead light on the retina at the back of the eye to correct myopia. Surrounding the central lens, hundreds of small lenslets alter peripheral light in a way that, the manufacturer says, seems to signal the eye to slow its elongation. In a two-year clinical trial of 183 8- to 13-year-olds with myopia, MiyoSmart slowed myopia progression by 52 percent and yielded 62 percent less axial elongation among the youngsters who wore these lenses compared with those who wore single-vision lenses. As of February 2022, the lenses weren’t available in the United States.

The Technology: Orthokeratology (Ortho-k)

Orthokeratology (also called corneal refractive therapy, or CRT) refers to the use of contact lenses to reshape the eye and diminish myopia. Rather than solely redirecting light, these contacts exert gentle hydraulic pressure on the eye to encourage the surface, or epithelium, to assume a better shape for optimal focus. Vision improvements are temporary and revert to the normal state when lenses are removed. But the effect can be maintained if the lenses continue to be worn. Most lenses are designed to work overnight, conferring benefits for the following day. Here are some of the research-tested products.

• MiSight lensesThe first contact lenses to win FDA approval in 2019, MiSight was developed by CooperVision for youngsters ages 8 to 12. Dispensed as one-day disposables, the super-thin lenses reportedly slow myopia by 59 percent in children, when compared with single-vision one-day lenses, according to a study published in August 2019 in Optometry and Vision Science. The manufacturer says that in clinical trials, youngsters successfully mastered the proper insertion, removal, and cleaning of the lenses.
• Procornea DreamLite night lenses Also from CooperVision, Procornea DreamLite lenses are inserted overnight to reshape the cornea during sleep, resulting in clear, sharp vision the following day. The lenses are intended for people who don’t want to be bothered with correction devices during the day. In May 2021, the product received European approval for slowing myopia progression in children and young adults.
• Acuvue Abiliti Johnson & Johnson’s myopia-correcting brand, Abiliti is a one-day, soft, disposable therapeutic lens made of silicone hydrogel that’s specifically designed for children ages 7 to 12. Produced in collaboration with contact lens manufacturer Menicom, the newest Abiliti lens is part of a group of products — some FDA approved — devised for youngsters with myopia.

Tracking and Treating Medical Conditions

Glasses and contacts are acquiring new capabilities to function as diagnostic tools, drug dispensers, and condition trackers. Xiao-Yu Song, MD, PhD, the global head of research and development for Johnson & Johnson Vision, sees their purpose and power expanding beyond sharpening sight. “Most people aren’t aware that disposable soft contact lenses are one of the first examples of what we now call ‘wearable technology,’” she says. 

Here are just a few of the services being developed for conditions within the eye or on its surface.

Measuring eye pressure Historically a thief of normal vision, glaucoma occurs when the fluid pressure within the eye — intraocular pressure — increases to a point where it threatens the health of the optic nerve, which transmits images to the brain. Although prescription drops can control many cases, without a visit to the doctor there was previously no way to determine whether the pressure had stabilized or was increasing. Now a variety of technologies incorporated into special contact lenses are being used to monitor the eye to detect and warn of pressure fluctuations. Some designs use color changes to alert the wearer, such as the lens described in the May 21, 2020 issue of Lab on a Chip, while others are linked with applications that can notify the doctor, the wearer, or both of rising pressure. Contacts that deliver glaucoma drugs directly to the eye are also being tested as an alternative to manually instilling drops every day. 

Treating eye allergies A Johnson & Johnson Vision contact lens, Acuvue Theravision with Ketotifen was approved by the FDA in early March 2022 as the first contact lens to deliver medication directly to the eye’s surface. The manufacturer states that the disposable soft contact lens distributes targeted and consistent doses of the ophthalmic antihistamine in minutes upon insertion. The medication is intended to provide relief from itching and discomfort for up to 12 hours while continuing to provide vision correction over longer periods of time.

Addressing color blindness ChromaGlasses aren’t yet unobtrusive, but these head-mounted spectacles, still in prototype, are among several devices being developed to help people with mild color blindness see more vibrant colors by increasing the contrast between different wavelengths. The glasses aren’t effective for people with severe color blindness, nor does their effect last after they are removed. They are meant to address the most common types of red-green color vision defect, called “anomalous trichromacy,” experienced by an estimated 8 in 100 men (8 percent) and 1 in 200 women (0.5 percent), according to an article published in July 2020 in the newsletter Phys.org. Contact lenses with color-shifting technology, constructed from artificially fabricated thin films, are also being laboratory tested, as described in an article published in March 2020 in Optics Letters.

Monitoring blood sugar and blood alcohol levels A review in the March 2022 issue of Applied Materials Today notes that glucose levels, the critical marker in diabetes, can be detected in tear film through special sensors embedded within spectacles. When glucose-detecting lenses are linked to a computer application, glucose levels can be continually monitored. Ideally, that could eliminate the need for frequent finger sticks to monitor blood glucose levels. Similar glucose-sensing technology is being developed for embedding in contact lenses. These same technologies can also be adapted to detect blood alcohol levels.

Tracking vitamin deficiency The tear film also harbors a wealth of information about vitamin levels. Antioxidant supplements have been shown to be effective in preventing the progression of some kinds of macular degeneration, and adequate levels of vitamin D are important for a variety of medical conditions — including heart disease, high blood pressure, and diabetes. These special glasses or contacts, described in an article published in July 2019 in Biosensors and Bioelectronics, can serve as early warning systems of worsening problems that supplements may help.

Lubricating dry eyes A long-established technology employs special goggles or retrofitted eyeglasses that are fabricated to preserve moisture by enclosing the area around the eye to retard the evaporation of tears, the major cause of dry eye disease (DED). The specs safeguard against the drying effects of wind, smoke, sprays, particulates, and other environmental irritants that can damage the eye’s surface. The protective eyewear is considered indispensable for bicyclists and motorcyclists, since they’re routinely bombarded by powerful air currents. By contrast, wearing regular contact lenses can worsen the problem.

“Approximately a third of the 45 million people wearing contacts have some contact-lens related dryness,” says George Grobe, vice president for research and development, vision care, and surgical products at Bausch & Lomb.

Filtering Harmful Light

Breakthrough developments in materials and technology can shield the eyes from harmful light, whether it originates from an electronic screen, direct UV sunlight, or the relentless glare of snow. Here are some of those filtering correctives.

The Technology: Total Blue

Many researchers disagree about whether computer vision syndrome (CVS, discomfort and eyestrain from too much time spent viewing electronic screens) is caused by the computer-emitted blue light itself or the glare. While exposure to blue light before bedtime can suppress the melatonin that signals the body to sleep, thus disrupting the normal sleep cycle, the American Academy of Ophthalmology reported in 2021 that there is “no scientific evidence that the light coming from computer screens is damaging to the eyes.” Many retailers are betting on blue light–blocking specs anyway.

• Kodak Total Blue This eyewear was cited in a 2019 report in Optometry and Vision Science for efficiently screening out 100 percent of ultraviolent light as well as the very high-energy visible blue light produced by electronics. The glasses allow the low-energy blue light believed essential for true color perception and to maintain normal sleep cycle rhythms to pass through to the eye.
• Prevencia The French company Crizal says that its blue-block specs are the “first preventive lens offering selective protection from blue-violet light and UV rays.” The product differentiates itself by claiming that it eliminates only the harmful kinds of blue light, those that are blue-violet, while allowing blue-turquoise light to pass through. The product was reviewed in the International Review of Ophthalmic Optics.
• Antireflective and polarizing coatings Also offered as anti-glare coatings, these are touted for their ability to reduce eyestrain and improve viewing. By eliminating reflections to allow 99 percent of light to get through, the coatings render the lenses virtually invisible. They also allow lenses to deliver clear vision in rain or while underwater. At the same time, polarizing filters, long used to capture better photographic images, reduce glare caused by light reflected from surfaces such as water, snow, or metal.

Dynamically Altering Vision Correction

The human eye is changeable over time, but spectacles have remained fairly static since Benjamin Franklin invented bifocals more than 200 years ago. Advances in electronics and materials science, liquid crystal technology, are speeding innovation and spawning a new category of “dynamic vision” glasses. These smart spectacles can sense, and alter, their corrective shape based on each user’s needs.

“The industry in general is moving in the direction of totally customized glasses,” says Vitale. 

The Technology: Electronic Focusing Lenses 

Leading the way in dynamic vision is eyewear that utilizes liquid crystals sandwiched between super-thin layers of plastic. The combination enables these eyeglasses to reconfigure with a swipe along the earpiece. The switch triggers an electrical current that can transform a distance lens into a near, reading prescription.

One of the early entrants in this emerging field is from an Israeli company, DeepOptics, that pioneered the concept alongside researchers at the Massachusetts Institute of Technology (MIT). Its initial offering takes aim at presbyopia, a common age-related reduction in near vision.

• 32 North DeepOptics These dynamic spectacles are initially available as nonprescription sunglasses that can transform into reading glasses via a switch on the earpiece that alters the liquid crystals.

“Liquid crystal has a different refractive index depending on the voltage applied,” says Yariv Haddad, DeepOptics’ cofounder and chief executive officer. The glasses are linked to an application that helps the wearer program the ideal magnification for sharp near vision.

The company says that the sunglasses’ thickness and weight are identical to that of ordinary specs; the cost, less than $500. Haddad says that the specs will be shipped sometime this summer.

DeepOptics says that it plans to begin selling prescription vision correction with the reading-glass capability as early as 2023.

Augmenting the Real World

Shortly after Google Glass eyewear was introduced, in 2013, the products faded from view for most American consumers. They continued, however, to take segments of business and industry by storm. “These spectacles are still out there, being used in manufacturing facilities and for technical support in situations where it’s tough to look back and forth while performing a task,” says Vitale.

The Technology: Lightweight Glasses and Contacts

The original Google Glass eyewear consisted of lightweight and unobtrusive specs with embedded augmented reality (AR) enabled to superimpose information on the wearer’s field of vision. That concept survives in specialized lightweight headsets and in ordinary specs available to the public.

The same approach is being adapted for contact lenses that can project visual information onto the wearer’s field of vision, leaving the hands free.

AR has proven its mettle for those with failing vision, empowering them to decipher information critical to daily life, from transit schedules and restaurant menus to warning signs and directives.

“In the low-vision population, these glasses are game changers,” says Andrea Zimmerman, OD, the in-house optometrist at the New York City–based nonprofit Lighthouse Guild. “The applications can take any image from, say, an iPhone camera, and allow someone with low vision to zoom in and zoom out on important details that they could not otherwise see.” 

Sony, Microsoft, Lenovo, Ray-Ban, Meta, Snap, and Qualcomm are among the many major companies casting their lot with the smart glass set. Others include the following.

• Norm Glasses Norm (for “the new normal”) Glasses is working to produce eponymous eyewear — fully functional computers that project information directly onto the lens. The specs would allow real-time viewing of anything that can be incorporated into an application, from recipe instructions to the product information encoded into retail barcodes. The manufacturers also claim they can place calls, take photographs, play tunes, and, yes, function like ordinary glasses. Norm Glasses will also be offered as prescription spectacles and sunglasses, but as of publication, there’s no clear date for delivery. The cost of the “basic” version online is projected to be about $489.
• Vue Smart Glasses At just under $200, Vue’s connected specs can be ordered as prescription or “plano” (nonprescription), arriving, the company says, within a few weeks. This line of eyewear can be ordered with clear lenses, blue light filters, or various sunglass lenses and offers voice-based applications to make or take calls and play audiobooks and music.
• Razer Anzu As this portion of the market heats up, the self-styled “gaming peripherals brand” is selling its smart marketing specs for less than $130 shipped. The glasses, available with blue light filtering or polarized sunglass lenses, offer built-in microphone and speakers, Bluetooth connection, and a touch interface from which to manage calls, change music tracks, or activate a voice assistant.

Specially designed contact lenses are also being readied for AR, including:

• Mojo Vision Dubbed “invisible computing,” Mojo Vision’s contact lens-based AR is being advertised as the world’s densest, dynamic microLED display. The lenses dispatch visual information directly to the retina via a 70,000-pixel projector the size of a grain of sand. Overlaid onto the field of vision, it can display information provided by any linked program.

Although not yet ready for the consumer marketplace, the lenses are in active development with the Disney Company and other major investors.

With other improvements being pioneered, it’s entirely possible that the current roster of innovations will be updated — or even outdated — within the decade. Some researchers say that new technological breakthroughs will ultimately render obsolete today’s electronic must-haves: cellphones, notebook computers, and smartwatches. Hands-free wearables will become too convenient, they say.

That’s especially likely to happen if, as Vitale predicts, the purchase price for smart vision correction dramatically plummets as the devices’ sophistication improves.

“When the first LED televisions came out, they cost about $8,000 each,” he recalled. “Now they’re down to $300 or less, and they do more. The same thing will happen with all the advanced glasses and contact lenses as they become smarter and better able to multitask.”